The nation’s top medical organization is asking the Centers for Disease Control and Prevention to revise opioid prescription guidelines to protect patients from unintended consequences.
The American Medical Association (AMA) said in a letter to the CDC that arbitrary limits and restrictions put on opioid prescriptions leave patients stigmatized because of their prescription, and often still lacking the pain treatment they desire.
“To make meaningful progress toward ending this epidemic, a broad-based public health approach is required,” AMA Executive Vice President and CEO James L. Madara wrote. “We are now facing an unprecedented, multi-factorial and much more dangerous overdose and drug epidemic driven by heroin and illicitly manufactured fentanyl, fentanyl analogs, and stimulants. We can no longer afford to view increasing drug-related mortality through a prescription opioid-myopic lens.”
The CDC should consider not only the lack of evidence that limits or restrictions have on improving outcomes for patients with pain but that it should also consider its own advice on misapplying guidelines to justify specific doses or quantity restrictions.
“Hard thresholds should never be used. Where such thresholds have been implemented based on the previous CDC Guideline, they should be eliminated,” Madara wrote.
The AMA also urged the CDC to recommend that “public and private payer policies must be fundamentally altered and aligned to support payment for non- pharmacologic treatments and multimodal, multidisciplinary pain care,” and to ensure that patients with pain and co-occurring opioid use disorder still receive effective pain treatment.